Thresholds for surfactant use in preterm neonates: a network meta-analysis
The result's identifiers
Result code in IS VaVaI
<a href="https://www.isvavai.cz/riv?ss=detail&h=RIV%2F00023698%3A_____%2F23%3AN0000003" target="_blank" >RIV/00023698:_____/23:N0000003 - isvavai.cz</a>
Result on the web
<a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10313962/" target="_blank" >https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10313962/</a>
DOI - Digital Object Identifier
<a href="http://dx.doi.org/10.1136/archdischild-2022-324184" target="_blank" >10.1136/archdischild-2022-324184</a>
Alternative languages
Result language
angličtina
Original language name
Thresholds for surfactant use in preterm neonates: a network meta-analysis
Original language description
ObjectiveTo perform a network meta-analysis of randomised controlled trials of different surfactant treatment strategies for respiratory distress syndrome (RDS) to assess if a certain fraction of inspired oxygen (FiO(2)) is optimal for selective surfactant therapy. DesignSystematic review and network meta-analysis using Bayesian analysis of randomised trials of prophylactic versus selective surfactant for RDS. SettingCochrane Central Register of Controlled Trials, MEDLINE, Embase and Science Citation Index Expanded. PatientsRandomised trials including infants under 32 weeks of gestational age. InterventionsIntratracheal surfactant, irrespective of type or dose. Main outcome measuresOur primary outcome was neonatal mortality, compared between groups treated with selective surfactant therapy at different thresholds of FiO(2). Secondary outcomes included respiratory morbidity and major complications of prematurity. ResultsOf 4643 identified references, 14 studies involving 5298 participants were included. We found no statistically significant differences between 30%, 40% and 50% FiO(2) thresholds. A sensitivity analysis of infants treated in the era of high antenatal steroid use and nasal continuous positive airway pressure as initial mode of respiratory support showed no difference in mortality, RDS or intraventricular haemorrhage alone but suggested an increase in the combined outcome of major morbidities in the 60% threshold. ConclusionOur results do not show a clear benefit of surfactant treatment at any threshold of FiO(2). The 60% threshold was suggestive of increased morbidity. There was no advantage seen with prophylactic treatment. Randomised trials of different thresholds for surfactant delivery are urgently needed to guide clinicians and provide robust evidence.
Czech name
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Czech description
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Classification
Type
J<sub>imp</sub> - Article in a specialist periodical, which is included in the Web of Science database
CEP classification
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OECD FORD branch
30209 - Paediatrics
Result continuities
Project
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Continuities
N - Vyzkumna aktivita podporovana z neverejnych zdroju
Others
Publication year
2023
Confidentiality
S - Úplné a pravdivé údaje o projektu nepodléhají ochraně podle zvláštních právních předpisů
Data specific for result type
Name of the periodical
ARCHIVES OF DISEASE IN CHILDHOOD-FETAL AND NEONATAL EDITION
ISSN
0003-9888
e-ISSN
1468-2044
Volume of the periodical
108
Issue of the periodical within the volume
4
Country of publishing house
GB - UNITED KINGDOM
Number of pages
9
Pages from-to
333-341
UT code for WoS article
000897876000001
EID of the result in the Scopus database
2-s2.0-85144847450